LLWWBBKK883322--FFMM..iinndddd iiii 22//2233//1111 1100::5522::2266 AAMM Gross Anatomy LLWWBBKK883322--FFMM..iinndddd ii 22//2233//1111 1100::5522::2222 AAMM LLWWBBKK883322--FFMM..iinndddd iiii 22//2233//1111 1100::5522::2266 AAMM Gross Anatomy Kyung Won Chung, Ph.D. Distinguished Professor and Vice Chairman David Ross Boyd Professor Samuel Roberts Noble Presidential Professor Director, Advanced Human Anatomy Department of Cell Biology, College of Medicine University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA Harold M. Chung, M.D. Associate Professor of Medicine VCU Medical Center Virginia Commonwealth University Division of Hematology and Oncology Bone Marrow Transplant Program Director, Radioimmunotherapy Program Richmond, Virginia, USA LLWWBBKK883322--FFMM..iinndddd iiiiii 22//2233//1111 1100::5522::2266 AAMM Acquisitions Editor: Crystal Taylor Managing Editor: Stacey Sebring Vendor Manager: Bridgett Dougherty Designer: Holly Reid McLaughlin Compositor: Aptara, Inc. Seventh Edition Copyright © 2012, Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Two Commerce Square Baltimore, MD 21201 2001 Market Street Philadelphia, PA 19103 All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval s ystem without written permission from the copyright owner. The publisher is not responsible (as a matter of product liability, negligence, or otherwise) for any injury resulting from any material contained herein. This publication contains information relating to general principles of medical care that should not be construed as specifi c instructions for individual patients. Manufacturers’ product information and package inserts should be reviewed for current information, including contraindications, dosages, and precautions. Library of Congress Cataloging-in-Publication Data Chung, Kyung Won. Gross anatomy / Kyung Won Chung, Harold M. Chung. – 7th ed. p. ; cm. – (Board review series) Includes bibliographical references and index. ISBN 978-1-60547-745-9 (alk. paper) 1. Human anatomy–Outlines, syllabi, etc. 2. Human anatomy–Examinations, questions, etc. I. Chung, Harold M. II. Title. III. Series: Board review series. [DNLM: 1. Anatomy–Examination Questions. 2. Anatomy–Programmed Instruction. QS 18.2] QM31.C54 2012 611–dc22 2011004830 DISCLAIMER Care has been taken to confi rm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omis- sions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publi- cation. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publi- cation. However, in view of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is p articularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. LLWWBBKK883322--FFMM..iinndddd iivv 22//2233//1111 1100::5522::2277 AAMM To Young Hee, my wife, closest friend, and companion, for her love, care, inspiration, and encouragement. KWC To Kathie, my wife, best friend, and soul partner, and to my daughters, Kira, Liah, and Maia, for their love, support, and understanding. HMC LLWWBBKK883322--FFMM..iinndddd vv 22//2233//1111 1100::5522::2277 AAMM LLWWBBKK883322--FFMM..iinndddd vvii 22//2233//1111 1100::5522::2277 AAMM Preface Anatomy is the science of studying and understanding the structure and organization of the body. The art of medicine requires a strong foundation in the basic medical sci- ences, and anatomy is a keystone in that foundation. This concise review of human anatomy is designed for medical, dental, graduate, physician associate, nursing, phys- ical therapy, and other health science students. It is intended to help students prepare for the United States Medical Licensing Examination (USMLE), the National Board Dental Examination, as well as other board examinations for students in health-re- lated professions. It presents the essentials of human anatomy in the form of con- densed descriptions and simple illustrations. The text is concisely outlined with related board-type questions following each section. An attempt has been made to include all board-relevant information without introducing a vast amount of material or entangling students in a web of details. Even though this book is in summary form, its content presents key elements of the full-text version with abundant clinical infor- mation. However, it is not intended to use as a primary textbook for a comprehensive study of diffi cult concepts and fundamentals. ORGANIZATION As with previous editions, the seventh edition begins with a brief introduction to the skeletal, muscular, nervous, circulatory, and organ systems. The introductory chapter is followed by chapters on regional anatomy. These include the introduction, upper limb, lower limb, thorax, abdomen, perineum and pelvis, back, and head and neck. Once more, anatomy forms a foundation of clinical medicine and surgery and is a visual science of human structures. Thus, the success of learning and understanding largely depends on the quality of dissection and on clear, accurate illustrations. Many of the illustrations are simple schematic drawings, which are used to enhance the stu- dent’s understanding of the descriptive text. A few of the illustrations are more com- plex, attempting to exhibit important anatomic relations. The considerable number of tables of muscles will prove particularly useful as a summary and review. In addition, the end-of-chapter summaries and summary charts for muscle innervation and action, cranial nerves, autonomic ganglia, and foramina of the skull are included in order to highlight pertinent aspects of the system. Test questions at the end of each chapter emphasize important information and lead to a better understanding of the material. These questions also serve as a self- evaluation to help the student uncover areas of weakness. Answers and explanations are provided after the questions. vii LLWWBBKK883322--FFMM..iinndddd vviiii 22//2233//1111 1100::5522::2277 AAMM viii Preface FEATURES OF THE NEW EDITION ■ Expanded and Updated Clinical Correlations Clinical correlatio,ns emphasize the importance of anatomical knowledge by relating basic anatomy to actual medical practice. They are designed to chal- lenge the studentenhance genuine understanding of anatomy, and encourage assimilation of information. The clinical correlates are set in boxes and placed at relevant locations in the text. Many clinical correlation boxes have been edited, combined, or regrouped. ■ End-of-Chapter Summaries These summaries help students review essential information quickly and rein- force key concepts. ■ Developmental Anatomy The study of human embryology (normal development) and teratology (abnor- mal development) provides an important basis for the understanding of defi ni- tive human anatomy and is useful in guiding the students to apply the knowledge of human embryology to the clinical settings and problem-solving skills. More- over, short summaries highlight the most important embryologic concepts in an effective, logical, and understandable way. ■ Review Test The chapter review tests consist of questions and answers that refl ect the guide- lines set forth by the National Board of Medical Examiners and the current USMLE format. The questions reinforce the key information and test basic ana- tomic knowledge and the students’ ability to interpret their observations and solve clinical problems. Therefore, clinically oriented questions and applica- tions have been signifi cantly increased because their fundamental utility is based on the relationship of anatomy to clinical medicine. Embryology ques- tions are added and many test questions have been rewritten. They are cen- tered on a clinical situation that requires in-depth anatomic knowledge and problem-solving skills. Rationales are provided for correct and incorrect answers. ■ Comprehensive Examination As before, the comprehensive examination is placed at the end of the book. It is useful in identifying specifi c knowledge defi cits, fi lling the gaps in knowledge of clinical anatomy, and serving as an independent study, review resource, and self-assessment tool in preparation for the course fi nal and state and national board examinations. ■ Extensive Medical Art and Four-Color Illustration Program Illustrations play critical roles in assisting students visualize anatomic struc- tures, clarify diffi cult concepts, and help identify their functional and clinical characteristics. Some illustrations have been rearranged or redrawn, and new fi gures and images have been incorporated. Furthermore, the addition of new four-color illustrations refl ects more artistic efforts, illuminates the beauty of the anatomical architecture of human tissues and organs, clarifi es intricate concepts, enhances the quality and clarity of the images, and facilitates a quick recall of the text materials. Radiograms, angiograms, computed tomographic scans, and magnetic resonance images are included in the text and in the review test section, aiding the learning process of anatomic structures and their LLWWBBKK883322--FFMM..iinndddd vviiiiii 22//2233//1111 1100::5522::2277 AAMM